One of the challenges that many IC patients struggle with is dry mouth, a common side effect of both antihistamines and antidepressants. To ease these symptoms, we have often turned to dry mouth products that contain xylitol. A sugar alcohol, xylitol has long been considered safe for use in humans and is commonly found in a wide variety of low sugar foods such as sugarless gum, mouthwash and chewable vitamins. You can more significant quantities in various candies, cake mixes, ketchup, BBQ sauce, pancake syrup, peanut butter and others.
Researchers at the Cleveland Clinic have just released the results of an alarming new study that has linked xylitol with heart attack and stroke.(1) This follows a 2023 study that found another sugar alcohol, erythritol, was linked to higher rates of heart attack and stroke.(2)
Dr. Stanley Hazen, the lead researcher of the team, said “This study again shows the immediate need for investigating sugar alcohols and artificial sweeteners, especially as they continue to be recommended in combatting conditions like obesity or diabetes.” He continued “It does not mean throw out your toothpaste if it has xylitol in it, but we should be aware that consumption of a product containing high levels could increase the risk of blood clot related events.”
In this new study, researchers identified that high levels of circulating xylitol were associated with an elevated three-year risk of cardiovascular events in an analysis of more than 3,000 patients in the U.S. and Europe. A third of patients with the highest amount of xylitol in their plasma were more likely to experience a cardiovascular event. To confirm the findings, the research team conducted pre-clinical testing and found that xylitol caused platelets to clot thus increasing the risk of both heart attack and stroke.
Researchers also tracked platelet activity from people who ingested a xylitol-sweetened drinks and found that every measure of clotting ability significantly increased immediately following ingestion of xylitol but not glucose.
Xylitol Use For Dry Mouth
I’ve never jumped on the artificial sweetener bandwagon because it never tasted good to me. And I wasn’t aware of the newer sugar alcohol sweeteners until one fateful afternoon when I bought a new type of Balance Bar (since discontinued) to try. Within an hour, I was in the bathroom with severe cramping and diarrhea that lasted for days. I called the company and they explained that this was their first product that used sugar alcohol as a sweetener and that some people don’t tolerate sugar alcohols well. Clearly, I was one of those.
In my 30’s, I developed dry mouth from some medications and turned to Biotene Products (including: gum, toothpaste and mouthwash) with modest success. I learned that I could have a little but if I ate too much it landed me in the bathroom with bowel problems. So, I used it sparingly.
In the past few years, I have used Xylimelt candies daily as a sweet treat and it worked beautifully as long as I didn’t eat too many. But, if I felt a little constipated, I would add one or two more and found that it helped move things along. But now that I’m older, I’m much more invested in keeping my heart as healthy as possible. Based upon this study, I will certainly use far less than I have in the past to reduce the risk of blood clots and have already thrown my last bottle out.
Yet again, this shows that truly natural foods and sweeteners (i.e. honey) are far safer than those produced in industrial labs.
References
- Witkowski, et al. Xylitol is prothrombotic and associated with cardiovascular risk. Eur Heart J. 2024
- Cleveland Clinic Study Finds Common Artificial Sweetener Linked to Higher Rates of Heart Attack and Stroke. February 27, 2023
